The invention relates to a surgical guiding device for reconstruction of the anterior cruciate ligament.
Guiding devices for reconstruction of the anterior cruciate ligament are generally used for positioning and/or aligning drilling channels into a bone, these channels being essential to enable anterior cruciate ligament transplants to be inserted. Depending on the surgical method (single-bundle or double-bundle reconstruction), one or two of these drilling channels are created in the bone. To create these drillholes, first the alignment wires are inserted in the bone with the aid of the guiding device. These are then used later in the operation to guide cannulated drills used to open out the drilling channels to a wider diameter, that is, to the diameter of the anterior cruciate ligament transplants that will subsequently be inserted.
A guiding device for single-bundle reconstruction is known from German published patent application DE 101 46 452 A1. This instrument has a guide arm with a permanently fixed mounting for a drill. A guide hook extends away from the guide arm in arched manner, such that the distal end of the hook is facing away from the guide arm and is opposite the mounting for the drill. In this way, the distal end of the guide hook is able to encircle the bone that is to be drilled so that the drill's exit point from the bone may be marked. However, it is only possible to make one targeted drillhole in the bone using these guiding devices, so the instrument is not suitable for use in double-bundle reconstruction.
A similar guiding device, which is suitable for double-bundle reconstruction, is known from German published patent application DE 10 2007 057 075 A1. On this instrument, two openings are provided in the guide hook. A first alignment wire is passed through the first opening to create a first drillhole. Then, the alignment wire is removed from the first opening and mounted in the second opening to position the guide hook correctly for creating the second drillhole. The drawback with this guiding device is that the bone bridge between the two drillholes to be created cannot be defined and adjusted precisely, particularly if the implants are of different diameters.
International patent application publication WO 2006/125009 A2 discloses a further guiding device that is suitable for double-bundle reconstruction. This guiding device has two mountings on the guide arm for two drills or alignment wires, which can be positioned very flexibly with respect to one another and on the guide arm of the guide hook. However, the many adjustment options require a complex construction and manipulating this instrument is complicated. A similar guiding device is known from European patent application publication EP 1 917 921 A2.